Studies on the effectiveness of driver safety messages found that messages that focused on “fear arousal” were more likely to be rejected, while those that focused on concrete, doable behaviors were more likely to be accepted.

Ditto the results of a 2017 study: not a single a luxury sedan or sports car was among the top choices of high-income Americans. And then there's the complication that half the luxury cars in the US are bought by individuals with incomes of less than $100,000 a year (per the research firm Kantar Media TGI).

Regret is the recognition that one made a mistake and that an alternative action was possible. Regret requires consideration of what might have been, aka "counterfactual reasoning". In a phrase: coulda, shoulda, didn't.

…a 31% cut would get us to Denmark, which is good enough for me. The revised goal, then, would be to reduce annual healthcare spending to $2.3 trillion. In other words, we're looking for savings of a trillion dollars. Let the calculations begin!

…3. Increase federal and state budgets for the detection and prosecution of fraudulent medical billing, such as upcoding. 4. Greatly expand the number of nurse practitioners working as "full practice" primary care providers and gatekeepers, a status that allows them to work independently of a physician's clinical oversight. 5. Institute a no-fault medical malpractice system, much like the very successful one in Denmark. …

Take MRI scans, which cost about $1500 in the US. In Japan, the fixed price for an MRI scan is around $100 (depending on body part). Now you'd think that Japanese doctors wouldn't do that many MRIs because they couldn't make any money off them. But no - just the opposite: Japan leads the world in MRIs. What happened is that Japanese doctors asked MRI manufacturers to develop an inexpensive MRI scanner. And they got a cheap machine so they can do cheap MRI scans and still make a little profit. Sometimes the heavy hand of regulation can be a spur to innovation. …I say this as a lover of capitalism, for whom the word "corporate" elicits a sigh of gratitude.

Between the government and private insurers, medical office personnel spend an inordinate amount of time processing bills. What is reimbursable, what is not? What type of documentation is required? What billing code should we use? How much can we charge? And that is one big reason the US spends so much on healthcare administration. Time is money.

Doctors typically get a cut of the profits and that provides incentives for expensive care and/or high premiums (in the case of HMOs). Add in the relative ease of gaming the billing system, and you've got a recipe for out-of-control healthcare spending. It doesn't matter if the medical bills are paid by Medicare or private insurers. If the system of payment can be gamed, it will be gamed.

Last post was about outpatient services, specifically how reimbursement rates and physician profit-sharing arrangements contribute to the cost of outpatient care in the US. This post will address the cost of pharmaceuticals…A recent JAMA study ( Papanicolas et al, 2018) found that annual per capita spending on pharmaceuticals in the US was $1443, compared to an average of $680 for ten other developed countries.

…Thus, if you want to understand why these procedures cost so much, follow the reimbursement rates. For instance, in 1997 Medicare raised reimbursement rates in certain parts of the country. On average, areas with a 2 percent increase in payment rates experienced a 3 percent increase in care provision. Physicians charge what they can, and then some.

Given that old people consume way more healthcare than anyone else, why do other rich countries spend so much less on healthcare than the US, when the US has comparatively fewer oldsters? Something is very wrong with this picture. What is all that money going? … A lot is paying for outpatient care and administration, which alone account for half of US healthcare expenditures

In other words, rats make choices based on what they want and what they consider possible. They imagine the future, weigh the relative merit of different actions, seek additional information if needed, choose what to do, and then act. They are agents with desires and goals.

There's something about psychologizing that's invalidating. As if psychology was the science of human error. But does it have to be so? Humans are pretty good at tracking reality, thanks to biases and heuristics that work well most of the time. Error can be an ally in the search for truth.

Point is, no one has an emotional reaction to inequality without a sense of what it speaks to. Inequality is a concept for God's sake. It's not at the same level of concreteness as, say, a snake slithering in the grass.